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Evidence-based Knowledge Synthesis and Hypothesis Validation: Navigating Biomedical Knowledge Bases via Explainable AI and Agentic Systems
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[Evidence and Evidence Gaps - an Introduction].

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Summary

Evidence-based medicine (EbM) integration in healthcare requires robust clinical trials and systematic reviews. The German Clinical Trials Unit for Ear, Nose and Throat medicine, Head and Neck Surgery (DSZ-HNO) was founded to address evidence gaps and improve knowledge transfer in otolaryngology.

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Area of Science:

  • Otolaryngology, Head and Neck Surgery
  • Evidence-Based Medicine (EbM)
  • Clinical Research and Trials

Background:

  • Healthcare decisions rely on integrating existing evidence from clinical trials and systematic reviews to ensure optimal patient care, diagnosis, and prognosis.
  • Publication bias is a significant concern, necessitating public registration and availability of all clinical trial results, including those for planned or discontinued studies.
  • Evidence-based medicine (EbM), pioneered by Archibald Cochrane and David Sackett, has become integral to clinical practice and research over the past 25 years.

Purpose of the Study:

  • To support members of the German Society of Otolaryngology, Head and Neck Surgery (DGHNOKHC) and the German professional association of otolaryngologists (BVHNO) in generating, processing, and disseminating evidence.
  • To foster the transfer of knowledge into practice across diagnosis, treatment, prognosis, prevention, drug therapies, and surgical procedures within otolaryngology.
  • To systematically identify evidence gaps, prioritize research questions, and conduct clinical research, including studies on established procedures and post-approval therapies.

Main Methods:

  • Establishment of the German Clinical Trials Unit for Ear, Nose and Throat medicine, Head and Neck Surgery (DSZ-HNO) by the executive committees of DGHNOKHC and BVHNO.
  • Assisting members in identifying evidence gaps and in the planning and execution of systematic reviews and clinical trials.
  • Initiation of pilot projects, including a BMBF-funded clinical trial for sudden hearing loss and a survey to identify evidence gaps in otolaryngology.

Main Results:

  • The DSZ-HNO has been founded to provide a structured support system for clinicians in hospitals and medical practices.
  • Initial projects, such as a clinical trial for sudden hearing loss and an evidence gap survey, have been launched.
  • The initiative aims to facilitate the conduct of large-scale trials to test therapies and diagnostics under real-world conditions.

Conclusions:

  • The establishment of the DSZ-HNO offers a feasible and reasonable structure to aid otolaryngologists in clinical research.
  • This initiative is crucial for anchoring the principles of evidence-based medicine into daily clinical practice.
  • The DSZ-HNO will enhance the generation, processing, and dissemination of evidence, ultimately improving patient care in otolaryngology.